Everyone experiences the occasional "blue day" or a =
period=20
of feeling "down." It also is normal to feel sadness =
or grief=20
after a loss. Sadness is a part of life. But chronic =
feelings=20
of sadness are not a normal part of life. Depression, =
a=20
serious medical disorder, differs vastly from the =
transitory=20
state of feeling "down in the dumps."

Depression produces a profound low mood and =
influences a=20
person=E2=80=99s thoughts, feelings, health, and =
behavior. It is an=20
illness, just like heart disease and cancer are =
illnesses. At=20
one time or another, depression will afflict more than =
25=20
percent of the population. It strikes all ages, all =
races, all=20
economic groups, and both sexes. However, women are =
the=20
victims of depression twice as often as men. It is a =
major=20
cause of alcohol and drug abuse and other addictions.=20
Fortunately, depression can be successfully treated in =
approximately 80 percent of cases.

Depression is not something to be ashamed =
of. It is=20
not a character flaw or a sign of personality =
weakness.=20
Moreover, it is not a "mood" that a person can "snap =
out of,"=20
any more than a person can "snap out of" =
diabetes.

1 Depression=20
strikes the legal profession more often than any other =
profession. This article explores the issue of =
depression, its=20
signs and symptoms, the reasons for its prevalence in =
the=20
profession, some specific problems depression poses, =
its=20
impact on professionalism, and how to get help.=20

Symptoms of Depression and Contributing=20
Factors

According to Dr. Amiram Elwork, a clinical =
psychologist and=20
director of the Law & Psychology Training Program =
at=20
Widener University in Minnesota, the symptoms of =
depression=20
come in clusters and include the following:

Many factors can contribute to depression. For some =
people,=20
a number of components seem to be involved; for =
others, a=20
single factor can trigger the illness. Depression also =
strikes=20
for no apparent reason. According to the National =
Mental=20
Health Association, however, common factors =
contributing to=20
depression are as follows:

1.Biological: People with depression =
typically have an imbalance of certain brain chemicals =
called=20
"neurotransmitters," which help brain cells =
communicate with=20
each other. Any imbalance can disrupt the =
brain=E2=80=99s=20
mood-regulating system.

2. Cognitive: People with negative thinking =
patterns=20
and low self-esteem are more likely to develop =
depression.=20
Optimism in adulthood seems to have its roots in the =
nurturing=20
and care of parents during childhood.

3

3. Gender:Women experience =
depression at=20
nearly twice the rate of men. While the reasons for =
this are=20
still unclear, they may include female lifespan =
hormonal=20
changes. Another reason may be women=E2=80=99s =
multiple=20
responsibilities and consequent stress.

5. Medications:The side effects of =
some=20
medications can bring about depression.

6. Genetic:A family history of =
depression=20
increases the risk of developing the illness. Studies =
of twins=20
and adopted children seem to suggest that the risk has =
a=20
genetic component.

7. Situational:Difficult life =
events, such=20
as divorce, financial problems, or the death of a =
loved one=20
can contribute to depression. It also is more likely =
to arise=20
among those who have suffered stress over a long =
period of=20
time.

Depression in the Legal =
Profession

In a study of more than 100 occupations, lawyers =
had the=20
highest rate of depression.

4 In fact, =
lawyers are=20
almost four times more likely to experience depression =
than=20
the general population.5 Aside =
from depression,=20
one in four lawyers also experience feelings of =
inadequacy and=20
inferiority in personal relationships, as well as =
anxiety or=20
social alienation, at much higher rates than the =
population at=20
large.6

Especially among lawyers, depression can be=20
life-threatening. Surveys of lawyers in Washington and =
Arizona=20
reveal that most lawyers suffering from depression =
also have=20
suicidal fantasies.

7 A =
disproportionate=20
number of lawyers commit suicide, unfortunately during =
middle=20
age, when they would be most productive.8 Some=20
attribute this to the depressed lawyer=E2=80=99s =
typical retreat into=20
isolation, which greatly enhances the risk of acting =
on=20
suicidal thoughts.9 As a result, one study =
concluded that=20
lawyers are at a much greater risk of acting on their =
suicidal=20
thoughts and succeeding in doing so.10

Why is depression such a problem in the profession? =
First,=20
the increase in the number of lawyers likely has led =
to=20
increased competition and diminishing personal =
relationships=20
with other lawyers.

11 Second, =
new=20
technology creates an unrelenting and faster work=20
pace.12 Also, the law is overwhelmingly complex =
today.=20
Changing legal standards make it difficult to know how =
to=20
advise clients, and courts render so many decisions =
that it is=20
not easy to understand what the law actually is. The =
only=20
certainty is that whatever the causes, lawyers suffer=20
increased rates of burnout, disillusionment, and=20
dissatisfaction, which can lead to attorney neglect of =
files,=20
anxiety, depression, substance abuse, or =
suicide.13

Because depression impacts productivity in the =
workplace,=20
lawyers toiling under its burdens can cause =
irreparable damage=20
to clients, law firms or offices, and the legal =
profession, as=20
well as to their own health.

14 A major =
hurdle for=20
depressed lawyers is to realize they are, in fact, =
depressed.=20
Depression is insidious. Often, those who suffer from=20
depression do not recognize it as such. This may be =
because=20
those who have lived with suffering for so long are =
used to=20
feeling depressed or are out of touch with their=20
feelings=E2=80=94being depressed can have a numbing =
effect.=20

Distinctive Lawyer Personality=20
Traits

Empirical research suggests that lawyers have =
personality=20
characteristics that distinguish them from the general =
population.

15 Some aspects of the lawyer =
personality can=20
exacerbate depression and hinder acknowledgment that =
there may=20
be a problem. For example, research on personality =
traits of=20
lawyers reveals they have a low interest in emotional =
concerns=20
and interpersonal matters; a disproportionate =
preference for=20
"thinking" as opposed to "feeling";16 a =
greater than normal=20
incidence of psychological distress, including =
depression; and=20
substance abuse problems.

Lawyers are trained to be rational and objective. =
This=20
training, combined with the devaluation of emotional =
concerns=20
and feelings, can become obstacles to seeking help. =
Due to=20
their unique personality traits, lawyers may not =
recognize=20
their own problem until the disciplinary committee =
comes=20
knocking on the door. Lawyers also have more =
"masculine"=20
traits, including being argumentative, competitive,=20
aggressive, and dominant, any one of which can =
contribute to=20
social isolation.

17 Socially isolated lawyers may =
not have the=20
peer or family support to help them become aware that =
they may=20
be suffering from depression. Moreover, due to these =
masculine=20
traits, lawyers may perceive their need for help as a=20
character weakness, deny the problem, and sink deeper =
into=20
depression=E2=80=99s depths.

Obviously, lawyers suffering from the crushing =
burden of=20
depression are likely to violate these basic tenets of =
professional conduct because the depression overwhelms =
every=20
aspect of life. Hence, Colo.RPC 1.16(a)(2) =
specifically=20
prohibits lawyers from accepting or continuing =
representation=20
if their mental condition materially impairs the =
ability to=20
represent the client. Additionally, if partners or =
direct=20
supervisors are aware of that mental impairment, they =
must=20
take steps reasonably to ensure that it will not lead =
to=20
professional conduct violations.

18

How to Help=E2=80=94Or to Get =
Help

Because lawyers are so susceptible to depression, =
which can=20
create problems of professionalism in the law firm and =
the=20
courts, it is critical for colleagues to be watchful =
for=20
warning signs. It also is important for lawyers who =
have=20
symptoms of depression to seek help before their law =
practices=20
and family life suffer.

Recognizing a Colleague=E2=80=99s =
Problem

Lawyers who work in a law firm or organization have =
an=20
advantage. Depressed lawyers are not hard to recognize =
if=20
other lawyers pay more attention to "interpersonal =
concerns."=20
Even in the absence of such sensitivity, certain =
behaviors can=20
signal depression. These include decreased =
productivity,=20
absenteeism, morale problems, uncharacteristic lack of =
cooperation, complaints about always being tired, =
disruptive=20
behavior, and substance abuse.

Early treatment equates with less time lost at work =
and=20
increased productivity. It also is a way to circumvent =
poor=20
judgment decisions that can lead to professional=20
misconduct.

22Encourage the colleague to =
get help. A=20
family physician can adequately diagnose and treat the =
condition or refer a specialist, if=20
needed.

Getting Help for Yourself

Today=E2=80=99s anti-depressant drugs are truly a =
godsend. There=20
are a wide variety of such medications, the best known =
of=20
which is probably Prozac. A family physician is well =
versed in=20
the pros and cons of these medications. All can be =
effective=20
at restoring the chemical balance in the brain. One =
drawback,=20
however, is that these drugs take a long time to start =
working; in some cases, up to a month. This lag may =
discourage=20
some from continuing the treatment. However, even if =
the=20
particular drug first prescribed is ineffective, =
another may=20
be prescribed with success. These drugs are very=20
powerful and should be taken only by prescription =
and=20
under the supervision of a medical doctor.

Psychotherapy also is helpful. A person will =
progress more=20
quickly in therapy once the antidepressants sweep away =
depression=E2=80=99s low mood and negative thinking. =
Additionally,=20
psychotherapy is vital in addressing the underlying =
problems=20
that triggered the depression. It also can be the =
forum for=20
discovering adequate coping strategies for stressors =
that can=20
lead to depression.

Conclusion

Depression is all too pervasive in the legal =
profession.=20
Although the individual attorney may be prone to =
developing=20
depression, empirical research reveals that attorneys =
as a=20
group have personality characteristics that =
distinguish them=20
from the general population and make them more =
vulnerable.=20
Depression among lawyers can have serious professional =
consequences and can impact not only the lawyer =
suffering from=20
depression, but the firm or organization as well. =
Therefore,=20
it is important to identify the suffering as =
depression and to=20
get help quickly when its symptoms =
arise.

NOTES

1. See Bakke, "My =
Experience=20
with Depression: Brainstorm," 73 Wisconsin =
Lawyer (Dec.=20
2000), which is a first-hand account of one =
lawyer=E2=80=99s struggle=20
with depression, at http://www.wisbar.org/wislaw=20
mag/2000/12/qol.html.

=C2=A9 2004 The Colorado Lawyer and =
Colorado Bar=20
Association. All Rights Reserved. Material from =
The=20
Colorado Lawyer provided via this World Wide =
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server is protected by the copyright laws of the =
United=20
States and may not be reproduced in any way or =
medium=20
without permission. This material also is =
subject to the=20
disclaimers at http://www.c=
obar.org/tcl/disclaimer.cfm?year=3D2004.=20